Community Strains of Methicillin-Resistant<i>Staphylococcus aureus</i>as Potential Cause of Healthcare-associated Infections, Uruguay, 2002–2004

Benoit, Stephen R.; Estívariz, Concepción F.; Mogdasy, Cristina; Pedreira, Walter; Galiana, Antonio; Galiana, Álvaro; Bagnulo, Homero; Gorwitz, Rachel J.; Fosheim, Gregory E.; McDougal, Linda K.; Jernigan, Daniel B.

doi:10.3201/eid1408.071183

Cited by 44 publications

(29 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The geographical isolation of Chile may be responsible for this trait, and this concept is further supported by the low frequency of community-acquired meticillin-resistant Staphylococcus aureus in Chile, which is also very frequent in other South American countries, such as Argentina (Tokumoto et al, 2007), Uruguay (Benoit et al, 2008) and Brazil (Ribeiro et al, 2005). There are other countries in which class A carbapenemases, i.e.…”

Section: Carbapenem-resistant Enterobacteriaceae In Chilementioning

confidence: 95%

Porin alterations present in non-carbapenemase-producing Enterobacteriaceae with high and intermediate levels of carbapenem resistance in Chile

Wozniak

Villagra

Undabarrena

et al. 2012

Journal of Medical Microbiology

View full text Add to dashboard Cite

The main goal of this work was to identify the mechanisms responsible for carbapenem resistance in 61 Chilean clinical isolates of Enterobacteriaceae (Enterobacter spp., Serratia marcescens, Morganella morganii, Escherichia coli and Klebsiella pneumoniae) with reduced susceptibility to at least one carbapenem (ertapenem, imipenem or meropenem). All of the isolates were analysed for the presence of carbapenemases, extended spectrum b-lactamases (ESBLs), AmpC enzymes and outer-membrane proteins. None of the isolates exhibited carbapenemase activity nor did they have any of the carbapenemase genes that were screened for. Most of the 61 strains produced at least one ESBL and/or one AmpC enzyme and either lost their porins or had altered porins according to sequence analysis. The distribution of ESBLs and AmpC enzymes was different among the species studied. Resistance in K. pneumoniae and E. coli isolates was associated with ESBLs; in M. morganii isolates, resistance was attributed to overexpression of an AmpC enzyme; and in Enterobacter spp. isolates, resistance was associated with both types of enzymes. In K. pneumoniae isolates, porin integrity was more a determinant of carbapenem resistance than the presence of ESBLs, whereas in isolates of Enterobacter spp., M. morganii and S. marcescens, the presence of an overexpressed AmpC enzyme was associated with higher imipenem and meropenem MIC values. Therefore, carbapenem resistance in Chilean isolates is not due to true carbapenemases but rather to a combination of porin loss/alteration and b-lactamase activity. The fact that carbapenemases were not detected in this study is unique, given that many countries in the region have already reported the presence of these enzymes.

show abstract

Section: Carbapenem-resistant Enterobacteriaceae In Chilementioning

confidence: 95%

Porin alterations present in non-carbapenemase-producing Enterobacteriaceae with high and intermediate levels of carbapenem resistance in Chile

Wozniak

Villagra

Undabarrena

et al. 2012

Journal of Medical Microbiology

View full text Add to dashboard Cite

show abstract

“…Since the mid-1990s, MRSA ST30 clones with different pulsotypes and genetic characteristics have been reported from many parts of the world, including the United States, Japan, Latin America, Turkey, the Middle East, Egypt, and many countries in Western Europe (58,264,429,472,604,670,757,778,913,920). ST30 isolates reported from many regions, including PFGE type USA1100 in the United States, carry the genetic determinants of PVL and the SCCmec type IV element (58), but these clones have many spa types, suggesting continued evolution (92, 252,276,294,429,682,886 (184). Despite the high prevalence of this strain in Australia (670), it has rarely been identified on other continents (258).…”

Section: Other Prominent Ca-mrsa Genetic Backgroundsmentioning

confidence: 99%

Community-Associated Methicillin-ResistantStaphylococcus aureus: Epidemiology and Clinical Consequences of an Emerging Epidemic

2010

View full text Add to dashboard Cite

SUMMARY Staphylococcus aureus is an important cause of skin and soft-tissue infections (SSTIs), endovascular infections, pneumonia, septic arthritis, endocarditis, osteomyelitis, foreign-body infections, and sepsis. Methicillin-resistant S. aureus (MRSA) isolates were once confined largely to hospitals, other health care environments, and patients frequenting these facilities. Since the mid-1990s, however, there has been an explosion in the number of MRSA infections reported in populations lacking risk factors for exposure to the health care system. This increase in the incidence of MRSA infection has been associated with the recognition of new MRSA clones known as community-associated MRSA (CA-MRSA). CA-MRSA strains differ from the older, health care-associated MRSA strains; they infect a different group of patients, they cause different clinical syndromes, they differ in antimicrobial susceptibility patterns, they spread rapidly among healthy people in the community, and they frequently cause infections in health care environments as well. This review details what is known about the epidemiology of CA-MRSA strains and the clinical spectrum of infectious syndromes associated with them that ranges from a commensal state to severe, overwhelming infection. It also addresses the therapy of these infections and strategies for their prevention.

show abstract

“…More severe infections were present at low frequencies, such as bacteremia in 5% (2/43) and complicated pneumonia in 2% (1/43) (table 2). Classification was performed according to the definitions described before (29 (32) and Italy (33), and in Latin American countries, including Brazil (10), Argentina (14), Uruguay (11) and Colombia (12). In Colombia, for the last few years, the presence and circulation of CA-MRSA isolates have been described in hospitals in different regions, and the prevalence of this strain type in the hospital environment has been estimated to be approximately 39% (12,34).…”

Section: Clinical Analysismentioning

confidence: 99%

Staphylococcus aureus resistente a meticilina causante de infecciones comunitarias y de infecciones asociadas a la atención en salud en pacientes pediátricos del Hospital Universitario de Santander

Machuca¹,

González²,

Sosa³

2013

biomedica

View full text Add to dashboard Cite

Introduction: Methicillin-resistant Staphylococcus aureus (MRSA) is a frequent cause of infection in the pediatric population. Initially, MRSA was restricted to hospitals; however, outbreaks in the community among people without health care-related risk factors have been reported worldwide. Currently, MRSA is a frequent cause of both hospital and community-associated infections. Objective: To describe the relationships between the molecular characteristics of MRSA isolates (staphylococcal cassette chromosome mec (SCCmec) type and Panton-Valentine leukocidin (PVL) carriage) and the characteristics of infection (the origin and localization of infection) in pediatric patients at the Hospital Universitario de Santander in Bucaramanga, Colombia. Materials and methods: A total of 43 MRSA isolates were obtained from hospitalized pediatric patients. SCCmec typing (I-V), SCCmec IV subtyping and PVL carriage were determined and related to the clinical characteristics. Results: Among the MRSA isolates studied, SCCmec IVc was present in 77%, followed by 16% for SCCmec I and 2% for SCCmec IVa. Two isolates were not typeable (NT). PVL genes were carried by 88% of the MRSA isolates, including the SCCmec IVc/IVa and SCCmec I isolates. SCCmec IV caused both community-acquired infection (CAI) (47%) and nosocomial infection (HAI) (53%). SCCmec IV, PVL-positive MRSA was associated with both CAI (47%) and HAI (53%) and caused mostly SSTI and osteoarticular infection. Conclusions: These findings suggest that the presence of community-associated MRSA (CA-MRSA) (SCCmec IV and PVL positive) causes both health care-associated infection (HCAI) and nosocomial infection (HAI) in pediatric patients in Colombia. Staphylococcus aureus resistente a meticilina causante de infecciones comunitarias y de infecciones asociadas a la atención en salud en pacientes pediátricos del Hospital Universitario de Santander Introducción. Staphylococcus aureus resistente a la meticilina (SARM) es un agente frecuente de infección en la población pediátrica. Aunque inicialmente las cepas de SARM estaban restringidas a los hospitales, se han reportado a nivel mundial brotes de infección por SARM en individuos sin factores de riesgo y, actualmente, SARM es una causa frecuente de infecciones hospitalarias y comunitarias. Objetivo. Describir la relación entre las características moleculares de aislamientos de SARM (casete cromosómico estafilocócico mec SCCmec y leucocidina Panton-Valentine) y el origen de la infección y su presentación clínica en pacientes pediátricos del Hospital Universitario de Santander en Bucaramanga, Colombia. Materiales y métodos. Se incluyeron 43 aislamientos de SARM obtenidos de niños hospitalizados. La clasificación del SCCmec (I-V) y la subclasificación del SCCmec-IV se realizaron en todos los aislamientos. Además, los genes de la leucocidina Panton-Valentine se detectaron mediante amplificación por PCR. Las características moleculares fueron asociadas con las características clínicas de cada paciente. Resultados. Entre los 43 SARM tipific...

show abstract

Community Strains of Methicillin-ResistantStaphylococcus aureusas Potential Cause of Healthcare-associated Infections, Uruguay, 2002–2004

Abstract: Community-associated MRSA appears to be replacing healthcare-associated MRSA strain types in at least 1 facility and is a cause of healthcare-onset infections.

Cited by 44 publications

References 33 publications

Porin alterations present in non-carbapenemase-producing Enterobacteriaceae with high and intermediate levels of carbapenem resistance in Chile

Porin alterations present in non-carbapenemase-producing Enterobacteriaceae with high and intermediate levels of carbapenem resistance in Chile

Community-Associated Methicillin-ResistantStaphylococcus aureus: Epidemiology and Clinical Consequences of an Emerging Epidemic

Staphylococcus aureus resistente a meticilina causante de infecciones comunitarias y de infecciones asociadas a la atención en salud en pacientes pediátricos del Hospital Universitario de Santander

Contact Info

Product

Resources

About